Trump says don't start opioids to avoid addiction, but often they are prescribed
Posted August 8
President Donald Trump suggested on Tuesday that the way to avoid opioid addiction is never to start in the first place: "If they don't start, they won't have a problem."
But that comment -- and the idea people can avoid addiction by never taking opioids in the first place -- goes against a series of scientific studies that found many people get hooked on opioids after their doctor prescribes them painkillers.
"The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don't start, they won't have a problem. If they do start, it's awfully tough to get off," Trump said during a briefing on the opioid epidemic Tuesday at his golf club in New Jersey.
He added: "So if we can keep them from going on and maybe by talking to youth and telling them: No good, really bad for you in every way. But if they don't start, it will never be a problem."
A series of studies, however, have found one of the key variables in opioid addiction is a doctor's prescription, with many overdose deaths stemming from prescription opioid medications.
In 2014 alone, according to the Center for Disease Control and Prevention, more than 14,000 people died from overdoses involving prescription opioids. The same study found that as many as 25% of people who receive prescription opioids for long term non-cancer care deals with addiction.
It's an issue that has received a great deal of attention, too.
"This is a public health epidemic and one that is uniquely American," Dr. Sanjay Gupta, CNN's chief medical correspondent, wrote in 2016. "No other country in the world has the perverse amount of consumption as we do in the United States. And nowhere do we pay the price as dearly as with prescription opioid medications."
These studies cut at Trump's insinuation that opioid addiction could be curbed by stopping people from taking any opioids in the first place. The reality, experts say, is a solution to the problem could be in how doctors prescribe addictive drugs like hydrocodone, OxyContin and Percocet.
This was highlighted in a recent study in the New England Journal of Medicine that found some doctors are three times more likely to prescribe an opioid than other doctors.
"Physicians are just doing things all over the map," says Dr. Michael Barnett, an assistant professor at the Harvard T. H. Chan School of Public Health and one of the study's authors. "This is a call to arms for people to start paying a lot more attention to having a unified approach."
According to Barnett's study, some doctors prescribed opioids 24% of the time, more than three times as often as those doctors on the lowest scale. The study looked at how many opioid prescriptions emergency physicians gave to about 377,000 Medicare beneficiaries from 2008 through 2011.
Tom Price, Trump's secretary of Health and Human Services, did not address Trump's comments about the origins of addiction, but told reporters after the meeting that the Trump administration is focused on dealing with how prescriptions are written.
"I know that physicians and other providers have oftentimes sensed that there is an incentive to provide narcotic medication and we need to do all that we can to make certain that, yes, people are provided appropriate narcotic medication when necessary, but no more than necessary," Price said.
Trump's strategy of cutting off opioids before someone takes them appears to advocate for more targeting of kids and young adults with anti-drug messaging, evocative of the "Just Say No" ad campaign of the 1980s and early 1990s.
Trump's Office of National Drug Control Policy did not respond to questions about Trump's suggestion.